Change in health-related quality of life in patients with coronary artery disease predicts 4-year mortality

Int J Cardiol. 2014 Jun 1;174(1):7-12. doi: 10.1016/j.ijcard.2014.03.144. Epub 2014 Mar 26.


Aims: Self-reported health-related quality of life (HRQL) and changes in HRQL have been shown to predict mortality and/or adverse events in patients with coronary artery disease. MacNew Heart Disease HRQL questionnaire scores were examined as predictors of 4-year all-cause mortality.

Methods: Following referral for angioplasty in 385 patients with coronary artery disease, data were analyzed for differences in all-cause mortality by MacNew Global and subscale baseline and 1- and 3-month change scores (deteriorated ≥0.50; unchanged (-0.49 to +0.49); and improved ≥0.50 points).

Results: Mean baseline, 1-month, and 3-month MacNew Global and subscale scores were similar in survivors and non-survivors. Mean 1- and 3-month Global and emotional subscale and mean 1-month social subscale change scores decreased more in non-survivors than survivors. Compared with patients whose Global MacNew HRQL scores improved at one month, 4-year all-cause mortality hazard ratio (HR) was higher in patients whose HRQL deteriorated (HR, 1.70, 95% CI, 1.09, 2.65; p=0.021). Compared with patients whose Global MacNew HRQL improved at three months, 4-year all-cause mortality was higher in both patients whose HRQL had deteriorated (HR, 2.07, 95% CI, 1.29, 3.32; p=0.003) and patients with unchanged HRQL (HR, 2.62, 95% CI, 1.11, 6.17; p=0.028).

Conclusions: A deterioration of ≥0.50 points in MacNew HRQL Global scores at both one and three months is predictive of 4-year all-cause mortality. Serial HRQL information may be useful to identify patients at higher risk for adverse cardiac events and mortality and may have implications for determining follow-up frequency and treatment in individual patients.

Keywords: Health-related quality of life; Mortality; Predictors.

MeSH terms

  • Aged
  • Coronary Artery Disease / mortality*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Quality of Life*
  • Surveys and Questionnaires
  • Time Factors